Community Mental Health Nursing (RCMN)
MANAGING A CLIENT WITH HALLUCINATION AND ILLUSION IN THE COMMUNITY
This is where the RCPN assist client manage the distress associated with disordered perceptions e.g. hallucination and illusion.
Purpose
- Protect the client from harming self and others
- Help distinguish between reality and disordered perceptions
Indications
- Managing a client with hallucination and illusion in the community.
- Protecting the client from harming self and others.
- Helping the client distinguish between reality and disordered perceptions.
Equipment
- Client's records (manual or electronic)
- Teaching and learning materials e.g. videos, diagram etc.
- Pen and paper
- Related website
Preparation
- Prepare the client's records and teaching and learning materials.
- Ensure a calm and safe environment for the interaction.
Procedure steps
- Approach client in a calm manner and establish rapport (refer to procedure)
- Assess content of command hallucinations and or illusions
- Observe for verbal and nonverbal cues of hallucinations and illusions e.g. inappropriate laugh
- Verify your interpretation of what client is experiencing
- Acknowledge client's feelings and experiences
- Identify precipitating factors
- Interrupt the hallucinations and engage the patient's attention in other areas
- Direct the focus from hallucinational or illusional expressions to discussion of reality-centered situations
- Set limits for discussing repetitive hallucinational and illusional expressions (e.g. you have already told me about this, let's talk about something realistic)
- Validate interpretation of what is being said e.g. is this what you mean, who are they?
- Teach voice dismissal if possible e.g. singing out loud, listening to an audio player or reading out loud
- Serve prescribed medications and monitor the effect
- Document and report changes in hallucinations and illusions
Precautions
- Approach the client in a calm manner and establish rapport.
- Verify your interpretation of what the client is experiencing.
- Acknowledge the client's feelings and experiences.
- Serve prescribed medications and monitor the effect.
Aftercare
- Document and report changes in hallucinations and illusions.
- Direct the client's focus to reality-centred situations and set limits for repetitive expressions.
Nursing considerations
- Assess the content of command hallucinations or illusions and observe for verbal and nonverbal cues.
- Identify precipitating factors and interrupt the hallucinations by engaging the client's attention in other areas.
- Validate interpretations of what is being said before responding.
Patient education
- Teach voice dismissal techniques such as singing out loud, listening to an audio player or reading out loud.
- Help the client distinguish between reality and disordered perceptions.
Documentation
- Document and report changes in hallucinations and illusions.
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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